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Rest or Stay Active? Advice for Elbow, Wrist, and Hand Pain.

One recent study suggests the healthcare industry needs to change the advice being given about elbow, wrist, and hand pain. When we seek healthcare, the common advice is to rest to allow things to heal. As with other “injuries” such as low back pain this approach has been questioned.

Gareth Jones and colleagues in the UK suggest that allowing something to rest so that it will heal may be counterproductive. Remaining active and exercising has been show to stimulate healing or symptom improvement in other conditions. (1) Their work was published under the British Medical Journal last May.

To test this theory, Jones et al. set up an experiment for 538 patients going to outpatient physiotherapy for these conditions. The average patient had experienced ongoing pain for about a month. Everyone received physiotherapy. Some of the patients received normal advice to rest and protect the affected joint. Other patients received advice to stay active. The active patients were told that their condition was common, lasting damage was rare, and that recovery could be expected. The active group was also advised that early return to work with gradually increasing activity was helpful.

After six months, the patients advised to stay active proved 40% more likely to achieve full recovery. This evidence suggests that patients should be advised to remain active rather than advised to rest & protect when they seek healthcare for chronic elbow, wrist, and hand pain. There is actually a body of research suggesting this that has been accumulating for years. At Advanced Physiotherapy, we have long advised staying active and a gradual return to tolerable activity, along with exercise therapy to improve conditioning of the area, ergonomic enhancements, and other interventions. This and other evidence-based advice is yours with our compliments in our free e-book: Guide to Elbow Injuries [PDF Download].

 

Reference:

  1. Jones GT, Macfarlane GJ, Walker-Bone K, Burton K, Heine P, McCabe C, McNamee P, McConnachie A, Zhang R, Whibley D, Palmer K. Maintained physical activity and physiotherapy in the management of distal arm pain: a randomised controlled trial. RMD Open. 2019 Mar 1;5 (1): e000810.

 

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